Merzouqi Boutaina, El Bouhmadi Khadija, Zouhair Najib, Oukessou Youssef, Rouadi Sami, Abada Redallah Larbi, Roubal Mohamed, Mahtar Mohamed
Department of Otolaryngology, Head and Neck Surgery, 20 August 1953 Hospital, Casablanca, Morocco.
Ann Med Surg (Lond). 2021 Mar 8;64:102195. doi: 10.1016/j.amsu.2021.102195. eCollection 2021 Apr.
Esophageal perforation following an impacted foreign body (FB) is a rare and potentially life-threatening condition. Early clinical suspicion and imaging are important for a targeted management to achieve a good outcome. Endoscopic extraction of esophageal FB is a good and safe treatment alternative while the surgical procedure remains a necessary option for many patients. We present the case of a 50 years old woman, with no relevant medical history, who accidently ingested a chicken bone during a meal causing mild dysphagia. The patient consulted immediately but was reassured after normal clinical examination. We received the patient 9 days later with severe dysphagia and cervicomediastinal cellulitis. The cervical CT scan showed the significant collection and the FB impacted in the cervical esophagus wall. A first endoscopic exploration drained the pus and allowed the placement of a nasogastric tube. However, the removal of the FB required an open cervical surgery with the evacuation of the collection and the suture of the esophageal perforation followed by the placement of a drainage tube. The patient medical state improved rapidly and no further incidents were noted. The diagnosis of esophageal FB should be meticulous in order to avoid such life-threatening complications.
异物(FB)嵌顿后导致的食管穿孔是一种罕见且可能危及生命的疾病。早期临床怀疑和影像学检查对于有针对性的治疗以取得良好预后很重要。内镜下取出食管异物是一种良好且安全的治疗选择,而手术对于许多患者仍是必要的选择。我们报告一例50岁女性病例,该患者无相关病史,在进餐时意外吞食一根鸡骨,导致轻度吞咽困难。患者立即就诊,但经正常临床检查后得到安慰。9天后,患者因严重吞咽困难和颈纵隔蜂窝织炎前来就诊。颈部CT扫描显示有大量积液,异物嵌顿于颈段食管壁。首次内镜探查排出了脓液,并置入了鼻胃管。然而,取出异物需要进行颈部开放手术,排出积液,缝合食管穿孔,随后置入引流管。患者病情迅速好转,未再出现其他情况。食管异物的诊断应细致入微,以避免此类危及生命的并发症。